Claim total
$1,442.60
base $93.83 · payer covered $1,292.60
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1995-07-17
- Stop
- 1995-07-17
The parties
- Patient
- patient Adrian Isaiah Durgan
- Provider
- provider Nikia Mills
- Payer
- payer Medicaid
Record id
046903bc-0773-63cf-b924-7f38115f8400